AB1365 COMPARISON OF HOMOLOGOUS AND HETEROLOGOUS BOOSTER SARS-CoV-2 VACCINATION IN AUTOIMMUNE RHEUMATIC AND MUSCULOSKELETAL PATIENTS
Authors: D. Honfi, G. Szebeni, A. Balog
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Vaccine-induced immunity is very important for controlling the COVID-19 infection. The vaccination supports humoral and cellular immunity, and this is one of the main strategy for us. Various vaccines approved in the countries have been shown to reduce infection rates, severity, and mortality. <h3>Objectives</h3> We aimed to compare humoral and cellular immune responses after homologous or heterologous vaccination among patients with aiRMDs at their third vaccination with BNT162b2 or with two vaccinations followed by COVID-19 infection. We detected the anti-SARS-CoV2 antibody levels and measured the SARS-CoV-2 reactive B-, or T-cell mediated immunity in aiRMDs receiving homologous (Hom.), heterologous (Het.) vaccines or became infected (Inf.). <h3>Methods</h3> A single center observational study evaluated immunogenicity and safety of the third dose vaccines or after two-dose regimen of vaccine and COVID infection in patients with aiRMDs. Neutralizing anti-RBD antibodies and specific T-cell response were measured. <h3>Results</h3> We showed that following 4 months of the booster vaccination with the third dose of mRNA-based vaccine or after COVID infection, the positive (&gt;21.8 BAU/mL) neutralizing anti-RBD IgG antibody response was outstanding in all three patient groups, 95.5%, 100% and 100% of the homologous and heterologous as well as the SARS-CoV-2 infected groups. Taken together booster vaccinations or SARS-CoV-2 infection after completing 2 doses of the vaccination can lead to the production of neutralizing antibodies still protective in RMD cases after 4 months of the third antigen exposition. The booster vaccination reduces the frequency of hospital admissions and mortality with ai RMDs. The vaccinations are effective independently from the type of vaccine, the SARS-CoV-2 specific memory B-cell populations showed a statistically not significant but lower frequency in the infection group. Clinical activity of aiRMDs was not increased following booster vaccination. <h3>Conclusion</h3> Patients, who received a heterologous booster vaccine had a higher level of peripheral memory B-cells compared to those who had COVID-19 infection. Biologic therapy decreased the level of B-cells. Patients with a disease duration of more than 10 years had higher level of CD8+TNF-α+ and CD8+IFN-γ+ T-cells compared to patients who were diagnosed less than 10 years ago. The third booster mRNA-based vaccine was as much effective as in the homologous and heterologous patients groups compared who had COVID infection. <h3>References</h3> [1] Szebeni, G.J.; Gemes, N.; Honfi, D.; Szabo, E.; Neuperger, P.; Balog, J.A.; Nagy, L.I.; Szekanecz, Z.; Puskas, L.G.; Toldi, G.; et al. Humoral and Cellular Immunogenicity and Safety of Five Different SARS-CoV-2 Vaccines in Patients With Autoimmune Rheumatic and Musculoskeletal Diseases in Remission or With Low Disease Activity and in Healthy Controls: A Single Center Study. Front. Immunol. 2022, 13, 846248. [2]Honfi, D.; Gémes, N.; Szabó, E.; Neuperger, P.; Balog, J.Á.; Nagy, L.I.; Toldi, G.; Puskás, L.G.; Szebeni, G.J.; Balog, A. Comparison of Homologous and Heterologous Booster SARS-CoV-2 Vaccination in Autoimmune Rheumatic and Musculoskeletal Patients. Int. J. Mol. Sci. 2022, 23, 11411 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.